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What is ADHD?
How is ADHD diagnosed in children?
Inattention
Hyperactivity-Impulsivity
How is ADHD diagnosed in adults?
What are the effects of ADHD?
How does neurofeedback treat ADHD?
References

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that results in a person displaying a number of behavioural symptoms. The pattern of behaviour differs between individuals because each person has a different combination of symptoms and each symptom varies in severity. Some of the more common symptoms include:

Distractibility difficulty in sustaining attention, often getting distracted by other stimuli such as sights and sounds and losing concentration easily.
Impulsivity doing things without thinking, saying things out of turn and appearing impatient.
Hyperactivity not being able to sit still, constantly moving and fidgeting.
Insatiability continuing with a line of conversation, never appearing to be satisfied with an answer.
Social Clumsiness not picking up on subtle social clues, and so appearing tactless and overpowering.
Poor Co-ordination difficulty in performing multiple tasks, looking uncomfortable in their movements, and being clumsy.
Disorganisation not having structure to their tasks, often flitting between jobs, whilst also being messy.
Variability switching moods very quickly, having good and bad days.


How is ADHD diagnosed in children?

Making a formal diagnosis of ADHD is a complex process and involves a number of health professionals. However, the greatest difficulty is ensuring that symptoms are not just a reflection of other disorders, such as dyslexia, and that the symptoms are not masked by a co-morbid condition, such as asperger’s syndrome.

The official list of symptoms which healthcare professionals use to diagnose ADHD in children (diagnostic criteria DSM-IV1 or ICD-10) state that: -

The child must display 6 symptoms of either inattention or hyperactivity-impulsivity (or both) and symptoms must have been present for at least 6 months.


Inattention

Fails to pay close attention to details or makes careless errors in schoolwork, work or other activities
Has trouble keeping attention on tasks or play
Doesn't appear to listen when being told something
Neither follows through on instructions nor completes chores, schoolwork, or jobs (not due to failure to understand or a deliberate attempt to disobey)
Has trouble organising activities and tasks
Dislikes or avoids tasks that involve sustained mental effort (homework, schoolwork)
Loses materials needed for activities (assignments, books, pencils, tools, toys)
Easily distracted by irrelevant information
Forgetful


Hyperactivity-Impulsivity

Squirms in seat or fidgets
Inappropriately leaves seat
Inappropriately runs or climbs (in adolescents or adults, there may be only a subjective feeling of restlessness)
Has trouble quietly playing or engaging in leisure activity
Appears driven or "on the go"
Talks excessively
Answers questions before they have been completely asked
Has trouble waiting his/her turn
Interrupts others

The symptoms must begin before 7 years of age, and be present in at least two places, such as school and home. The disorder must negatively affect functioning in these places, and the symptoms must not occur solely because of a psychotic disorder (e.g. schizophrenia), or be better explained by an alternative disorder (e.g. mood, anxiety or personality disorder).

The above criteria enables three types of ADHD to be diagnosed as follows:

1. Combined Type: if both inattention and hyperactivity-impulsivity symptoms exist.
2. Inattentive Type: if only inattention symptoms exist (sometimes referred to as Attention Deficit Disorder)
3. Hyperactive-Impulsive Type: if only hyperactivity-impulsivity symptoms exist.


How is ADHD diagnosed in adults?

Diagnosing ADHD in adults involves the assessment of the following symptoms:

1. A sense of underachievement, of not meeting one’s goals (regardless of how much one has actually accomplished).
2. Difficulty getting organised.
3. Chronic procrastination or trouble getting started.
4. Many projects going simultaneously; trouble with follow through.
5. A tendency to say what comes to mind without necessarily considering the timing or appropriateness of the remark.
6. A frequent search for high stimulation.
7. An intolerance of boredom.
8. Easy distractibility, trouble focusing attention, tendency to tune out or drift away in the middle of a page or a conversation, often coupled with an ability to hyperfocus at times.
9. Often creative, intuitive, highly intelligent.
10. Trouble in going through established channels, following “proper” procedure.
11. Impatient; low tolerance of frustration.
12. Impulsive, either verbally or in action, as in impulsive spending of money, changing plans, enacting new schemes or career plans, and the like; hot-tempered.
13. A tendency to worry needlessly, endlessly; a tendency to scan the horizon looking for something to worry about, alternating with inattentiveness to or disregard for actual dangers.
14. A sense of insecurity.
15. Mood swings, mood lability, especially when disengaged from a person or a project.
16. Physical or cognitive restlessness.
17. A tendency toward addictive behaviour.
18. Chronic problems with self-esteem.
19. Inaccurate self-observation.
20. Family history of ADD or manic-depressive illness or depression or substance abuse or other disorders of impulse control or mood.

Twelve of the symptoms must be present. Other indicators include a history of childhood ADHD (although not necessarily formally diagnosed), and the symptoms not being explained by another medical or psychiatric condition.


What are the effects of ADHD?


ADHD is predominantly diagnosed in children, and has a profound impact on a child’s developmental learning. It is now recognized that children do not grow out of ADHD, indeed it has been estimated that 60% of the child ADHD population retain their symptoms into adulthood. Often people who carry ADHD symptoms into adulthood experience low self-esteem due to constant academic and social failures. This exacerbates the problem of having to cope with ADHD symptoms in adult life and can compromise an individual’s ability to achieve their potential. Studies that have evaluated outcome of adults with ADHD have reported a high incidence of anti-social disorders and substance dependent disorders.

Furthermore, the prevalence of ADHD sufferers in a prison population has been found to be 45%. These reports imply that the early treatment of ADHD is essential to provide the best chance for a child or adult to lead as normal a life as possible.


How does neurofeedback treat ADHD?

In the case of children with attentional difficulties, e.g. ADHD, brain research has documented an excess amount of slow-wave activity, called theta waves, in the pre-frontal cortex. Theta waves are especially predominant when children with ADHD try to engage in an active concentration task, which makes it very difficult for them to focus and sustain their attention on the task over a prolonged period of time. This is illustrated in the brainmaps below. Through neurofeedback training, children are taught to decrease their amount of theta activity and increase faster beta frequencies which enable them to sustain attention and focus on the task at hand.

Successful neurofeedback training has been shown to:

Reduce hyperactivity, attentional problems and externalizing behaviours in children with ADHD.
Reduce or completely stop the need for stimulant medication.
Increase general intelligence and school performance.
Improve social functioning and emotional skills.

If you or your child has been diagnosed with ADHD, PeakMind can offer neurofeedback training as a form of treatment. After the initial assessment, the neurofeedback training would usually consist of between 20-40 one-hour sessions.

 
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